FORM 2010/1
APPLICATION FOR A GRANT IN TERMS OF THE
LOTTERIES ACT (ACT No. 57 OF 1997)
INSTRUCTIONS
1. Please indicate (with a cross in the relevant box) if your application for a grant is in terms of:
□ Charities (Section 28 of the Act)
□ Sport and Recreation (Section 29 of the Act)
□ Arts, Culture and National Heritage (Section 30 of the Act)
□ Miscellaneous Purposes (any purpose other than the three categories above)(Section 31 of the
Act)
2. This application form is in five parts:
In section A: Details of the organisation.
In section B: Explanation on the funding required
In section C: Information of organisational finances.
In section D: Details of at least two contactable Referees.
In section E: Mandatory documents to be submitted with the application form
NB: If there is not enough space on this form for your answers, please use and attach further sheets of paper
........................................................................................................................................................................................................
SECTION A DETAILS OF YOUR ORGANISATION
A1 Name of organisation: …………………………………………………………………………………….
A2 Postal address: …………………………………………………………………………………………….
Postal code: ………………………….
A3 Street address: …………………………………………………………………………………………….
……………………………………………………………………………………………………………..
Province: ………………………………………
A4 Telephone number: ……………………………. A5 Fax number: …………………………...
A5 E-mail address: ……………………………………………………………………………………………
A6 When was your organisation formed? ……………………………………………………………………
A7 What kind of registered organisation are you? (E.g. Non-profit Organisation, Section 21 Company,
Public Benefit Trust): ….………………………………………………………………………………….
A8 When was your organisation registered? …………………………………………………………………
A9 Registration number: …………………………..… (Please attach a copy of your registration certificate)
A10 Details of the main contact person with executive powers (e.g. Manager/Programme Director)
Name: ………………………………….…………….……. Position: ……...……………………………
South African I.D. Number: ………………………………...…………… (Attach Certified Copy of ID)
Address: …………………………………………………….…………. Tel: ……………………………
A11 Details of a second contact person (e.g. Chairperson):
Name: ………………………………………………….….. Position: …………………………………
South African I.D. Number: ……………………………………….……… (Attach certified copy of ID)
Address: …………………………………………………………….….. Tel: ……...……………………